Membership Application
Membership Application:

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Note: After you submit the application information on this page, you will have the option of being redirected to PayPal to pay now via credit card online. Alternatively you may mail a check in to the below address or bring the money to any meeting.

Items marked in * are required.
* Name:
* Email:
* Address:
* City:
* State:
* Zip:
* Phone:
Member Since:
Breed(s) of Dog(s):
What is 1 + 1? (This is for anti-spam purposes. Just put 2 in the box.)
By entering my initials in the space below, I agree to the following:
As a condition of membership in the Lake Country Retriever Club, I do hereby waive my right and the right of my heirs and assigns to hold Lake Country Retriever Club, or its directors, officers, or employees liable or responsible in any way for any damage, injury, or death that may occur to myself or my family or any of my properties or belongings, including dog(s). In addition I agree to defend indemnify and hold harmless Lake Country Retriever Club and its directors, officers, and employees against any and all loss and liability, damages, and costs (including attorney fees) arising from or relating to my participation, or the participation of any dog in which I have an ownership interest or which I am handling, at any Lake Country Retriever Club event or activity. I understand that there are risks involved in the events and activities of the Lake Country Retriever Club, including without limitation dogs being allowed off leash from time to time and the use and discharge of firearms. I agree to adhere to the rules and regulations of the AKC. I agree to abide by the Constitution and By-Laws of the Lake Country Retriever Club. As a member of Lake Country Retriever Club, I agree to conduct myself in a responsible manner at all LCRC meetings, events and activities; and agree to use appropriate language in any public gathering; I agree to treat all other members, guests and visitors with courtesy and respect; I agree to use the utmost caution and safe conduct while participating in or attending any LCRC event or activity; and I acknowledge that my membership privileges can be suspended or terminated for inappropriate behavior or misconduct prejudicial to the interests of the Lake Country Retriever Club.

* My Initials:

Please mail a $45 check to the address below, or you may bring $45 to any meeting.
Lake Country Retriever Club
Dave Funk Secretary
17395 Goodhue Ave
Lakeville, MN 55044

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